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S T R A T E G I C A N A L Y S I S
What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current Strategic Analysis coverage may be affected. You
may keep this coverage if you elect Part D and this plan will coordinate with Part D coverage. See pages 7-9
of the CMS Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance (available at
http://www.cms.hhs.gov/CreditableCoverage/) which outlines the prescription drug plan provisions/options
that Medicare eligible individuals may have available to them when they become eligible for Medicare Part D.
If you do decide to join a Medicare drug plan and drop your current Strategic Analysis coverage, be aware
that you and your dependents may be able to get this coverage back.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with Strategic Analysis and don’t join a
Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher
premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium
may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did
not have that coverage. For example, if you go nineteen months without creditable coverage, your premium
may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay
this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you
may have to wait until the following November to join.
For More Information About This Notice Or Your Current Prescription Drug Coverage…
Contact your plan administrator.
NOTE:
You’ll get this notice each year. You will also get it before the next period you can join a Medicare
drug plan, and if this coverage through Cavalier changes. You also may request a copy of this notice at any
time.
For More Information About Your Options Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare &
You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be
contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
• Visit
www.medicare.gov
• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the
“Medicare & You” handbook for their telephone number) for personalized help
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is
available. For information about this extra help, visit Social Security on the web at
www.socialsecurity.gov
, or
call them at 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug
plans, you may be required to provide a copy of this notice when you join to show whether or not you
have maintained creditable coverage and, therefore, whether or not you are required to pay a higher
premium (a penalty).